Cardiac angiosarcoma is the most common malignant cardiac tumor.[1] According to existing literature, complete resection is the only proven effective treatment.[6] Others such as chemotherapy or radiotherapy were effective only in sporadic cases.[19–21] In this case, we aimed to discuss the effect of ifosfamide and epirubicin (IE) plus recombinant human endostatin (rh-endostatin) following palliative surgery. This evidence concerns the gene COL18A1 and heart neoplasm.